Iranian Journal of

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Background: Assessing the trend of ischemic heart diseases and the process of acute coronary care is one of the most important tools in monitoring the programs dedicated to control of ischemic diseases. The current project was developed to assess the feasibility of using routine data registered in clinical records for coronary event registration according to the standards of WHO/MONICA project.
Methods: Hospital records of 320 cases with primary diagnosis of acute coronary syndrome (80 cases from each quarter, July 2003-4) were evaluated according to sufficiency of data. Data were evaluated according to “internal consistency”, “change in the proportion of missing data in the time periods” and “the proportion of insufficient data”.
Results: Available data of hospital records were not sufficient to determine the diagnosis in 0.7% of cases In addition, they were resulted in a probable diagnosis in 11.2% of coronary events. Median percents of missing data regarding the prescribed drugs before event was more than 10% in both fatal and non-fatal coronary events (score 1 of 4). Median percents of missing data regarding the ECGs, cardiac enzymes and cardiac resuscitation was lower than 5% in non-fatal coronary events and lower than 2% in fatal cases (scores 2 and 3 of 4 relatively).
Conclusion: The quality of available registered data in the evaluated clinical records was comparable with many reporting units of MONICA project. Using the available clinical records seems to be effective and feasible for systematic registration of cardiac events.

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Research, as systematic way to discover, interpret, explain, predict, modify, and control events, entails the knowledge-based performance of individuals, organizations and systems. Today, knowledge is a tool for development, entrepreneurship, and improving economic value added rather than be a product of development. Also, Health systems, with their increasing complexity and scope, are causes and especially effects of an increasing rate of production, translation and implementation of health-related knowledge. This knowledge, with complexity, vast range, and variety, is produced by variety of research projects which mainly resulted from different problems addressed and presumed epistemic positions by them.

Authors believe that a comprehensive outlook on the variety of research projects in the health system could help to change the stereotypical view on research in the health system. To the best of our knowledge, this paper is a novel, narrative review gathering and presenting various existing classifications of research projects in the light of an inductive distinction. It aims to help specialists in the different levels of health system to profoundly understand and meticulously apply research results and to help researchers and research bodies to more accurately define, manage, prioritize, and allocate resources for future research projects to solve upcoming problems.

Different aspects used in this paper to classify health research projects are the followings: The purpose of research, the research paradigms, tacit or explicit knowledge, primary or secondary knowledge, relation with known disciplines, functions of the health system, the partnerships of non-academic persons, decision-making level, taxonomy of questions, and levels of evidence.

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Background: Older people are vulnerable in terms of health status. The elderly`s Khuzestan due to the very warm weather of this region are more at risk for health problems. This study is a report on the health status of the elderly in Khuzestan province in 2012.
Methods: This is a Cross-sectional study, with multi-level proportional cluster Random sampling among people aged ≤ 60 years of Khuzestan province. Nutritional status was assessed by Mini Nutritional Assessment (MNA), depressed mood screening was conducted with Geriatric Depression Scale-15 questionnaire, activities of daily living was evaluated using KATZ ADL and Lawton Instrumental ADL tools.
Results: In this study, 387 people participated. The prevalence of hypertension, diabetes mellitus, depressed mood, and anxiety in the participants, were 38.8%, 28.6%, 34.9 and 38.7, respectively. Hearing loss reported in 33.9% and vision impairment was in 62.2% of the participants. Memory impaired founded in 14.9% of the participants.  4.3% of the elderly suffered from malnutrition and 48.3% were at risk of malnutrition. Dysfunction in ADL were existed in 13.9% and 30.3% of the participants had some degrees of dysfunction in IADL.
Poly pharmacy (consumed more than 3 medications) was observed in 36.5% of older adults in this province. The most common health services need was medical services at home and then transport services.
Conclusion: Although the health status of the elderly in Khuzestan province  generally was not worse than the average of Iran, it needs that a special pay attention in some areas, such as hypertension, diabetes, nutritional status and lack of independence in activities of daily living in this age group.
 

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Background: It is critical to understand how accurately physicians can estimate the importance of each clinical finding in estimating the probability of a specific diagnosis in the process of clinical decision making. This study aimed to investigate whether physicians’ estimates of the importance of various clinical findings of ascites correlated with the positive likelihood ratios of these findings in diagnosis of ascites.
Methods: One hundred and ten physicians were asked to respond to a questionnaire. In this questionnaire they were presented with a clinical scenario about a patient suspected of having ascites followed by a list of clinical findings. Participants were asked to assign a weight (between 0 and 100%) to each clinical finding based on their perception of how much the presence of that finding changed the probability of ascites for the patient. Positive likelihood ratios of those findings were extracted from current best evidence. We investigated if the weights assigned by physicians were associated with the positive likelihood ratios of those findings.
Results: Significant differences were discovered between the weights assigned by the physicians and the positive likelihood ratios for each clinical finding. Significant positive correlation was observed between the weights assigned by different groups of physicians.
Conclusion: Physicians inaccurately estimated the importance of various clinical findings in the diagnosis of ascites. Further research is needed to determine if such inaccurate estimations would lead to any adverse clinical outcomes.

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Background: Type 2 diabete is a group of metabolic diseases whose common feature is elevated blood glucose levels due to defective insulin secretion, functional impairment, or both. Therefore, the aim of this study was to investigate the effect of Mindfulness Based Cognitive Therapy on reducing the disturbed eating behaviors, psychological distress and body worthiness in patients with type 2 diabetes.
Methods: This is a quasi-experimental study that was performed on type 2 diabetic patients of Kermanshah. The samples were randomly divided into two experimental and control groups and Body Worthiness Scale, Disturbed Eating Behaviors Scale, DASS-21 Scale, and the Mindfulness Questionnaire were used. Patients in the experimental group received sessions of Mindfulness Based -Cognitive Therapy each week two months. While the control group did not receive an intervention during this period. After completing the intervention sessions, again, both groups were asked to complete the research tool. Data were analyzed using descriptive statistics and inferential statistics (covariance). The findings were analyzed using Spss24 software.
Results: The results showed is effective in eating behaviors, psychological distress and the body worthiness.
Conclusion: Mindfulness- Based Cognitive Therapy on can decrease eating behaviors, psychological distress and enhance the body worthiness in patients with type 2 diabetes.